crossing96/oncoscreening huggingface dataset:
Distinct Clinicopathological Features of HER2-Negative, HER2-Low, and HER2-Overexpressing Urothelial Carcinoma in a Large Chinese Cohort.	PURPOSE: To investigate the expression patterns of Human Epidermal Growth Factor Receptor 2 (HER2) and their clinicopathological associations across the full spectrum (negative, low, and overexpression) in a large cohort of Chinese urothelial carcinoma (UC) patients. MATERIALS AND METHODS: A multicenter registry study (April 2023-March 2024) across eight Chinese tertiary hospitals included 1054 UC patients. Demographic, clinical, and pathological data were analyzed to identify factors associated with different HER2 expression levels (IHC 0 vs. 1+ vs. 2+/3+). A subset of patients was evaluated for additional IHC markers (e.g., CK20, GATA3, P16, Uroplakin3, Ki-67). RESULTS: Of 1054 patients, 18.6% were HER2-negative (IHC 0), 23.0% were HER2-low (IHC 1+), and 58.4% exhibited HER2 overexpression (IHC 2+/3+). Increasing HER2 expression was significantly associated with bladder tumor location (63.1% in IHC 2+/3+, p < 0.001), infiltrative tumors (61.1% in IHC 2+/3+, p < 0.001), and high-grade tumors (62.5% in IHC 2+/3+, p < 0.001). In a sub-analysis comparing HER2-low (1+) and HER2-overexpressing (2+/3+) groups, multivariable logistic regression confirmed bladder primary site (OR = 1.783, p = 0.001), infiltrative status (OR = 1.492, p = 0.027), and high-grade differentiation (OR = 1.918, p = 0.001) as independent predictors of HER2 overexpression, though the model's predictive ability was modest (AUC = 0.64). Expression of CK20, GATA3, P16, and Uroplakin3 also differed significantly between HER2-negative and HER2-positive groups. CONCLUSIONS: This study delineates distinct clinicopathological profiles for HER2-negative, HER2-low, and HER2-overexpressing UC in Chinese patients. These findings provide a crucial evidence base for refining personalized treatment strategies, particularly for HER2-targeted therapies like antibody-drug conjugates (ADCs), across the entire spectrum of HER2 expression.	bladder
Lymphoepithelioma-like carcinoma of urinary bladder - a rare subtype of urothelial carcinoma: a series of 12 cases.	Lymphoepithelioma-like carcinoma (LELCa) is a rare and aggressive subtype of urothelial carcinoma. This study presents a series of 12 cases of LELCa of the urinary bladder, highlighting its clinical and pathological features with treatment related details. The majority of cases presented with advanced-stage disease, often mixed with conventional urothelial carcinoma. Histologically, LELCa is characterized by sheets of undifferentiated tumor cells with prominent nucleoli in a syncytial growth pattern, accompanied by a dense lymphocytic infiltrate. Immunohistochemistry aids in confirming the epithelial nature of the tumor cells. Treatment strategies for LELCa are evolving. While radical cystectomy remains the standard treatment for advanced-stage disease, a multimodal approach, including chemotherapy and radiation therapy, may be considered, especially in cases with pure or predominant LELCa histology.	bladder
Association Between Preoperative 5-Aminolevulinic Acid Administration Timing and Perioperative Hypotension.	OBJECTIVES: Photodynamic diagnosis-assisted transurethral resection of bladder tumors with oral 5-aminolevulinic acid administration improves tumor visibility but results in perioperative hypotension. In 2024, the recommended timing of 5-aminolevulinic acid administration was revised to enable oral intake 2-8 h preoperatively, thereby making it easier to adjust the timing of drug administration and surgery. This study aimed to investigate the association between the interval from 5-aminolevulinic acid administration to the start of surgery and perioperative blood pressure. METHODS: We retrospectively analyzed 112 consecutive patients who underwent photodynamic diagnosis-assisted transurethral resection of bladder tumors from July 2022 to June 2024. Patients were categorized based on the time between oral 5-aminolevulinic acid administration and spinal or general anesthesia induction into the control (< 4 h) and extended time (≥ 4 h) groups. The perioperative blood pressure and severity of hypotension were compared between the two groups. RESULTS: The extended time group comprised fewer cases of moderate to severe hypotension than the control group (38% and 61%, respectively; p = 0.039). Blood pressure was significantly higher at several time points intraoperatively in the extended time group. Further, the extended time group required fewer doses of vasopressor agents (p = 0.025). CONCLUSIONS: An interval of more than 4 h from oral 5-aminolevulinic acid intake to anesthesia administration may reduce the risk of perioperative hypotension during photodynamic diagnosis-assisted transurethral resection of bladder tumors.	bladder
Prediction of recurrence using hematologic and urinary markers in intravesical Bacillus calmette Guerin treated bladder cancer.	Intravesical bacillus Calmette-Guérin (BCG) therapy reduces recurrence in non-muscle invasive bladder cancer (NMIBC). Various scoring models have been developed to predict recurrence, and this study aims to improve them by analyzing hematologic parameters and urinary immune cells. This study involved 88 bladder cancer patients treated with BCG between January 2022 and January 2023. Preoperative hematological parameters were recorded from two separate blood samples. Urine samples were collected before and after the first and sixth BCG instillations and analyzed by flow cytometry to determine the proportions of T cells, neutrophils, and myeloid-derived suppressor cells (MDSCs). Results were compared based on recurrence status and within-group changes. Six patients died from non-cancer causes, and five were excluded due to irregular follow-ups or external monitoring. Of the remaining 77 patients, followed for an average of 30 months, 12 experienced recurrence, and 65 did not. No significant differences were found in clinical or histopathological factors. Urine analysis revealed a higher Neutrophil/T cell ratio in patients with recurrence, while the T/MDSCs ratio increased significantly in the non-recurrent group post-BCG. Additionally, the MDSCs/Total Cell ratio significantly decreased post-treatment in the non-recurrent group. Peripheral blood analysis showed no significant differences in Neutrophil-Lymphocyte Ratio (NLR) and Lymphocyte-Monocyte Ratio (LMR). The results suggest a T cell-dominant immune response may prevent recurrence, while an MDSCs-dominant environment increases the risk. Changes in urinary T/MDSCs, MDSCs/Total Cell, and Neutrophil/T cell ratios may serve as potential biomarkers for predicting recurrence risk shortly after induction therapy.	bladder
Immune snapshots along the inflammation-to-cancer road in bladder urothelium.	"The inflammatory microenvironment formed by chronic inflammation is not only a major risk factor for cancer but also a well-recognized precursor to bladder cancer. However, the immunological transitions that occur along the inflammation-to-cancer continuum remain incompletely understood. This mini-review synthesizes recent advances in understanding how the immune microenvironment evolves from an inflamed yet non-malignant urothelium to invasive carcinoma. First, we discuss how persistent stimuli-such as chronic infection or exposure to carcinogens-disrupt immune homeostasis, leading to sustained interferon signaling, cytokine secretion, and immune cell infiltration. Second, during preneoplastic and dysplastic stages, the immune landscape gradually shifts toward an environment enriched in regulatory T cells and characterized by dysfunctional cytotoxic T cells. Furthermore, in established tumors, immune evasion is primarily driven by T cell exhaustion, myeloid cell-mediated immunosuppression, and fibroblast-associated immune exclusion. Finally, advances in spatial transcriptomics, single-cell technologies, and urinary exosomal profiling have enabled precise ""immune snapshots"" of these transitions, providing new avenues for biomarker development and therapeutic strategy selection. Mapping these dynamic immune states holds great promise for improving risk stratification, facilitating early detection, and enabling personalized immunotherapy, ultimately translating immune snapshots into actionable strategies for bladder cancer prevention and treatment."	bladder
EWSR1::BEND2 fusion sarcoma of the urinary bladder - a case report and review of literature.	In this case report we describe a Ewing-like high grade small round cell sarcoma of the urinary bladder in which an extremely rare EWSR1::BEND2 fusion was found. A 28-year-old male patient presented with hematuria and in the following examinations a large necrotic bladder tumor with spreading to adjacent prostatic tissue and multiple lung metastases were found. Histology showed a poorly differentiated small round cell tumor with perivascular rosettes and moderate membranous positivity for CD99. The methylation profile of the tumor did not match with any of the tumor entities grouped by the sarcoma classifier. With tumor agnostic methods, mainly next generation sequencing, novel fusions are being found at an accelerating rate. Our case adds to the expanding group of EWSR1 fusion neoplasms, and describes the effects of a Ewing sarcoma treatment protocol on this type of sarcoma. The relevance of traditional methods for detecting Ewing sarcoma with fluorescence in situ hybridization is decreasing as EWSR1 rearrangements are detected in tumors that show different clinical behavior and morphology. The classification of these tumors into WHO defined entities to guide treatment is a challenge.	bladder
The mediating effect of dyadic coping between illness perception and fear of disease progression in bladder cancer patients: A cross-sectional survey.	This study examines determinants of fear of disease progression (FoP) in bladder cancer patients and test dyadic coping (DC) as a mediator between illness perception (IP) and FoP. In this cross-sectional study, 126 bladder cancer patients underwent comprehensive assessment using a general information questionnaire, a fear of disease progression questionnaire-short form (FoP-Q-SF), a brief IP questionnaire and a DC inventory. Structural equation modeling with bootstrap resampling (n = 5000 iterations) quantified DC's mediating role in the IP-FoP pathway. The scores for IP, DC, and FoP in patients with bladder cancer were (37.73 ± 12.28), (125.18 ± 23.51), and (31.18 ± 9.46), respectively. Differences in the level of fear of disease progression across gender, age, literacy, income level, time of diagnosis, whether or not they relapsed, and the number of relapses were statistically significant (all P < .05). Mediation analysis demonstrated that DC functioned as a significant partial mediator in the IP-FoP relationship (indirect effect β = 0.328, 95% CI [0.227-0.452]), accounting for 59.6% of the total effect. IP exerts both direct effects on FoP and indirect effects mediated through DC. Consequently, clinicians should implement evidence-based dyadic interventions to mitigate cancer recurrence anxiety and enhance quality of life.	bladder
A systematic review of gene-mediated therapy in BCG-unresponsive NMIBC: emerging evidence and future perspectives.	OBJECTIVE: BCG-unresponsive non-muscle-invasive bladder cancer (NMIBC) represents a major therapeutic challenge, given the high risk of disease progression and the absence of validated bladder-sparing strategies. In this context, gene-mediated therapy has emerged as a promising bladder-sparing approach. METHODS: A systematic review of the literature available on Medline and Google Scholar was conducted to report the main oncological evidence, safety profile and future perspectives on gene therapies in BCG-unresponsive NMIBC. A total of 3157 records were screened and 13 references were included in our result section, including 8 articles from PubMed and 5 unpublished studies presented at conferences between 2023 and 2025. RESULTS: Gene-mediated therapies are emerging as a promising therapeutic strategy, with complete responses rates ranging from 53.4% to 82.9% at 3 months and from 24.4% to 57.1% at 12 months. Median duration of response rate ranging from 9,7 to 28 months. The safety profile is promising, with overall adverse events ranging from 47% to 91%, including grade ≥ 3 adverse events in 4% to 14% of cases, and no treatment-related deaths. The recent Food and Drug Administration approval of Nadofaragene firadenovec, is expected to provide relevant real-world clinical data. However, precise patient selection, the lack of predictive biomarkers for response or monitoring, and the cost-related challenges of these treatments remain major limitations. CONCLUSIONS: Gene therapies represent a novel and promising therapeutic approach for BCG-unresponsive NMIBC, with significant oncological efficacy and a favorable safety profile.	bladder
Assessing the Influence of Bladder Cancer on Upper Tract Urothelial Carcinoma Prognoses Following Radical Nephroureterectomy: A Retrospective, Propensity Score-Based Multicenter Cohort Study.	BACKGROUND: Bladder cancer (BCa) is relatively common in patients diagnosed with upper tract urothelial carcinoma (UTUC); however, the impact of BCa history on UTUC prognoses after radical nephroureterectomy (RNU) is unclear. This retrospective, multicenter cohort study aimed to assess this relationship and improve clinical decision making. MATERIALS AND METHODS: We conducted a comprehensive analysis of propensity score-matched (PSM) data from two Chinese centers and the Surveillance, Epidemiology, and End Results (SEER) database. Patients were categorized into three groups: BCa-UTUC (defined as patients with a BCa history or BCa occurring within 3 months following RNU); UTUC-BCa (defined as patients who had BCa for 3 months or more following RNU); or solely UTUC (defined as patients with no BCa). Kaplan-Meier analysis and log-rank tests were used to compare survival differences, and Cox's regression analysis was used to identify risk factors associated with overall survival (OS) and cancer-specific survival (CSS). RESULTS: Overall, 7249 cases were included (1010 from China, 6239 from the SEER database). PSM ensured well-balanced baseline characteristics. In the Chinese cohort, BCa-UTUC cases had significantly poorer CSS than solely UTUC (hazard ratio [HR] 2.334, 95% confidence interval [CI] 1.547-3.523; p < 0.001). UTUC-BCa also had worse CSS (HR 1.697, 95% CI 1.178-2.446; p = 0.005). BCa-UTUC was associated with worse OS (HR 2.404, 95% CI 1.703-3.393; p < 0.001). SEER findings were consistent, with both BCa-UTUC and UTUC-BCa linked to adverse CSS. CONCLUSION: BCa history, whether prior, concurrent, or subsequent, negatively affects UTUC prognosis after RNU, highlighting the need for enhanced surveillance and management for these high-risk patients.	bladder
Agreement between transurethral resection of bladder tumor and radical cystectomy pathology in patients with bladder cancer subtype histology: A retrospective cohort study.	INTRODUCTION AND OBJECTIVES: Transurethral Resection of Bladder Tumor (TURBT) is a diagnostic staging procedure for bladder cancer (BC). Its pathologic interpretation may be limited by cautery artifact, lack of spatial orientation of tumor specimens, inter-pathologist variance in identifying subtypes, and sampling bias. Accurately identifying subtype histology (SH) on TURBT is critical for clinical decisions. We compared the agreement between TURBT and radical cystectomy (RC) pathology in patients with SH BC. METHODS: We examined TURBT and RC pathology of patients who underwent RC at our institution. We included patients with pure SH and mixed histologies in either TURBT or RC specimens. Cohen's kappa coefficient was used to determine the degree of agreement between TURBT and RC. RESULTS: From 1135 RC performed, 650 (57%) patients had SH in either TURBT or RC; 225 patients were (y)pT0 at the time of RC and 36 patients had rare histologies, leaving 389 patients for analysis. 172 (44%) patients had an exact match between TURBT and RC. We found a high level of agreement between TURBT and RC in pure non-UC histology (kappa range: 0.82-0.98). In contrast, we found substantial (sarcomatoid; kappa 0.70), moderate (squamous, glandular, plasmacytoid, small cell/neuroendocrine; kappa range: 0.42-0.55) and fair (micropapillary; kappa 0.38) concordance between TURBT and RC in patients with UC mixed with SH. CONCLUSIONS: We found variable levels of agreement of SH detection between TURBT and RC. Agreement was high in pure non-UC histology. Further, we found that NAT, completeness of TURBT, and >50% SH at TURBT are associated with the persistence of SH at RC. Future efforts are needed to develop reproducible diagnostic tools for accurate characterization of SH in UC.	bladder
Fibroblast Growth Factor Receptor Alteration Testing for >3600 Patients with Locally Advanced/Metastatic Urothelial Cancer and Non-muscle-invasive Bladder Cancer: An Analysis of the Global ANNAR Biomarker Study.	BACKGROUND AND OBJECTIVE: Successful fibroblast growth factor receptor alterations (FGFRalt) testing is essential for identifying patients eligible for erdafitinib. This analysis of the global ANNAR biomarker study assessed the proportion of valid fibroblast growth factor receptor (FGFR) test results, reasons for test failure, and proportion of FGFRalt in locally advanced/metastatic urothelial cancer (mUC) and non-muscle-invasive bladder cancer (NMIBC). METHODS: Archival tumor tissue was tested using the QIAGEN therascreen FGFR real-time polymerase chain reaction kit, an approved companion diagnostic for erdafitinib. KEY FINDINGS AND LIMITATIONS: A total of 2706 mUC and 962 NMIBC samples were tested. The proportion of valid test results was significantly different between mUC and NMIBC (86% and 66%, respectively; p < 0.001), which declined with older archival sample age for both mUC (<1 yr 89% and ≥3 yr 77%; p < 0.001) and NMIBC (<1 yr 72% and ≥3 yr 43%; p < 0.001). For mUC, the proportion of valid test results was higher for the primary tumor than for metastatic samples (92% and 55%, respectively; p < 0.001) but similar between upper and lower tract disease (87% and 86%, respectively; p = 0.7). Common reasons for test failure were low tumor content and insufficient RNA. FGFRalt were found in 19% of mUC (83% mutations; 15% fusions) and 53% of NMIBC (92% mutations; 6.3% fusions) samples. Limitations include the lack of data on sample collection method. CONCLUSIONS AND CLINICAL IMPLICATIONS: This is the first and largest report on factors affecting FGFR test results. To ensure valid FGFR test results, adequate tumor sample amount, RNA quality, short archival sample age, and primary tumor samples are important factors.	bladder
Clinicopathologic and Prognostic Features of Sarcomatoid Urothelial Carcinoma: A Retrospective Study of 136 Patients With Emphasis on Early-Stage (pT1) Disease.	Sarcomatoid urothelial carcinoma (SUC) is a rare and aggressive subtype of bladder cancer. We retrospectively analyzed 136 patients diagnosed between 1993 and 2025. Clinicopathologic features, immunophenotype, PD-L1 expression, molecular alterations, and survival outcomes were assessed, with a focus on patients presenting with local low-stage (pT1) disease. The cohort included 96 males and 40 females (median age: 72). Most tumors (77%) were mixed with conventional urothelial carcinoma (UC), and 10% demonstrated heterologous differentiation. Tumor stage, lymphovascular invasion (LVI), and nodal metastasis were significantly associated with poor overall survival (OS; P <0.05). Fifty-four cases had CK5/6 and GATA3 immunohistochemical stains available; a mixed basal-luminal phenotype (CK5/6+/GATA3+) was most common (43%), though immunophenotypic grouping did not significantly impact survival. Twenty-two patients had PD-L1 immunostain performed at diagnosis, and most patients (82%) were PD-L1(+) with a CPS ≥10. Patients with CPS ≥50 trended toward improved OS. Panel-based sequencing was available for 6 patients and revealed heterogeneous mutations with few recurrent alterations. In our cohort, 10 patients had local low-stage (LLS/pT1) SUC, which is rare in SUC. The metastatic rate was 30%, and mortality was 40%. Findings in LLS patients with poor outcomes included large tumor, extensive invasion, tumor necrosis, and heterologous elements. LLS patients who underwent radical cystectomy (RC) had longer OS compared with those treated with transurethral resection of bladder tumor (TURBT) alone ( P =0.0269). 3/6 survival LLS patients had no residual tumor at RC. Our findings highlight the variable clinical courses of SUC, and call for more attention on this unique group of patients. The absence of residual disease in several pT1 patients following RC suggests that timely RC can have a favorable﻿ outcome in a subset of patients.	bladder
Cryotherapy for non-muscle invasive bladder cancer-preliminary results in an animal model.	OBJECTIVES: Initial treatment for Non-Muscle Invasive Bladder Cancer (NMIBC) has remained mostly unchanged in recent decades. Cryotherapy with CO2 has been commonly used in medicine for many years. In this study, we present the results of a pre-clinical study aimed at developing a novel cryoablation device to treat superficial low-grade bladder lesions. METHODS: Following initial technical and developmental studies, a rigid cryotherapy device was developed. A technical and efficacy assessment was conducted utilizing the porcine model. Overall, twenty-six ablation areas (up to four per animal) were evaluated. Following an initial routine cystoscopy, the bladder irrigation medium was replaced with CO2 insufflation, and each area was treated with 2 cycles (15 s each) of direct liquid CO2 spraying. After five days, the bladder epithelium was harvested for pathological evaluation. RESULTS: No bladder perforation was noted on pathology. The initial efficacy and usability of the device were demonstrated. Pathological evaluation of treated tissue morphology revealed focal mucosal edema and necrosis with associated surrounding reactive fibrosis, with penetration depths ranging from 0.5 to 4 mm, without profound muscularis propria damage. CONCLUSIONS: Initial results suggest the safety and feasibility of cryotherapy utilizing CO2 spraying. Pathological analysis confirms its potential in treating non-muscle invasive bladder cancer. Ongoing clinical studies aim to validate these results in human subjects, offering a potential paradigm shift in non-muscle invasive bladder treatment.	bladder